Evidence map›Paper›PMID 21775749›Full record

Trial reportDiabetes care2011

Observation on renal outcomes in the Veterans Affairs Diabetes Trial.

Lily Agrawal, Nasrin Azad, Nicholas V Emanuele, Gideon D Bahn, Derrick G Kaufman, Thomas E Moritz, William C Duckworth, Carlos Abraira, Veterans Affairs Diabetes Trial (VADT) Study Group

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00032487. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00032487 phase3completed

CSP #465 - Glycemic Control and Complications in Diabetes Mellitus Type 2 (VADT)

Ran2000Enrolled1,791Registered outcomes2Posted comparisons1ConditionsType 2 Diabetes MellitusArmsGlimepiride, Insulin, Metformin, Rosiglitazone
Open the trial in the graph
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Glucose targets for preventing diabetic kidney disease and its progression.The Cochrane database of systematic reviews · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Lily AgrawalDepartment of Medicine, Edward Hines, Jr., VA Hospital, Hines, IL, USA. lily.agrawal@va.gov
Nasrin Azad
Nicholas V Emanuele
Gideon D Bahn
Derrick G Kaufman
Thomas E Moritz
William C Duckworth
Carlos Abraira
Veterans Affairs Diabetes Trial (VADT) Study Group
Edward Hines, Jr. VA Hospital · USPhoenix VA Health Care System · USUniversity of Miami · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe Veterans Affairs Diabetes Trial (VADT) was a randomized, prospective, controlled trial of 1,791 patients with type 2 diabetes to determine whether intensive glycemic control would reduce cardiovascular events compared with standard control. The effect of intensive glycemic control and selected baseline variables on renal outcomes is reported. RESEARCH DESIGN AND

methodsBaseline mean age was 60.4 years, mean duration of diabetes was 11.5 years, HbA(1c) was 9.4%, and blood pressure was 132/76 mmHg. The renal exclusion was serum creatinine >1.6 mg/dL. Renal outcomes were sustained worsening of the urine albumin-to-creatinine ratio (ACR) and sustained worsening by one or more stages in the estimated glomerular filtration rate (eGFR).

resultsIntensive glycemic control did not independently reduce ACR progression but was associated with a significant attenuation in the progression of ACR in those who had baseline photocoagulation, cataract surgery, or both. The beneficial effect of intensive glycemic control increased with increasing BMI and with decreasing diastolic blood pressure (DBP). Intensive glycemic control was associated with less worsening of eGFR with increasing baseline ACR and insulin use. Baseline systolic blood pressure, triglycerides, and photocoagulation were associated with worsening of eGFR.

conclusionsIntensive glycemic control had no significant effect on the progression of renal disease in the whole cohort but was associated with some protection against increasing ACR in those with more advanced microvascular disease, lower baseline DBP, or higher baseline BMI and on worsening of eGFR in those with high baseline ACR.

Indexed as

AgedAlbuminuriaBlood PressureBody Mass IndexCreatinineDiabetes Mellitus, Type 2FemaleGlomerular Filtration RateHumansInsulinLogistic ModelsMaleMiddle AgedCreatinineInsulin

Identifiers

PMID21775749
PMCPMC3161270
OpenAlexW2160673679

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.